TY - JOUR
T1 - Postoperative course after first-stage palliation of hypoplastic left heart syndrome with right ventricle-to-pulmonary artery shunt; compared with classic Norwood procedure
AU - Iwasaki, Tatsuo
AU - Takeuchi, Mamoru
AU - Taga, Naoyuki
AU - Oe, Katsunori
AU - Shimizu, Kazuyoshi
AU - Morita, Kiyoshi
PY - 2004/9/1
Y1 - 2004/9/1
N2 - Background: A recent modification of the Nor wood procedure involves the use of a right ventricle-to-pulmonary artery (RV-PA) shunt to provide pulmonary blood flow for patients with hypoplastic left heart syndrome (HLHS). We investigated the hemodynamics after first-stage palliation of HLHS with RV-PA shunt compared with classic Norwood procedure with subclavian-to-pulmonary artery (BT) shunt. Methods: The postoperative course of 12 infants who had undergone first-stage palliation for HLHS using BT shunt (group BT: n=6) and RV-PA shunt (group RV-PA: n=6) were retrospectively reviewed and we obtained the following data: blood pressure, heart rate, inotropic support, atrial pressure, lactate, base excess, PaO2, FIO2. Results: The RV-PA shunt using a non-valved conduit provided higher diastolic blood pressure than the BT shunt, but no significant difference in heart rate, systemic blood pressure, inotropic support and atrial pressure was observed between the two groups. Although the infants in the group RV-PA required significantly more myocardial ischemic time for operative procedure than those in the group BT, the serum lactate level in the group RV-PA was significantly lower than those in the group BT. Conclusions: These results show that the RV-PA shunt provides a stable systemic circulation and abundant tissue oxygen supply. Excellent hemodynamics provided by RV-PA shunt is beneficial for infants undergoing stage I palliation for HLHS.
AB - Background: A recent modification of the Nor wood procedure involves the use of a right ventricle-to-pulmonary artery (RV-PA) shunt to provide pulmonary blood flow for patients with hypoplastic left heart syndrome (HLHS). We investigated the hemodynamics after first-stage palliation of HLHS with RV-PA shunt compared with classic Norwood procedure with subclavian-to-pulmonary artery (BT) shunt. Methods: The postoperative course of 12 infants who had undergone first-stage palliation for HLHS using BT shunt (group BT: n=6) and RV-PA shunt (group RV-PA: n=6) were retrospectively reviewed and we obtained the following data: blood pressure, heart rate, inotropic support, atrial pressure, lactate, base excess, PaO2, FIO2. Results: The RV-PA shunt using a non-valved conduit provided higher diastolic blood pressure than the BT shunt, but no significant difference in heart rate, systemic blood pressure, inotropic support and atrial pressure was observed between the two groups. Although the infants in the group RV-PA required significantly more myocardial ischemic time for operative procedure than those in the group BT, the serum lactate level in the group RV-PA was significantly lower than those in the group BT. Conclusions: These results show that the RV-PA shunt provides a stable systemic circulation and abundant tissue oxygen supply. Excellent hemodynamics provided by RV-PA shunt is beneficial for infants undergoing stage I palliation for HLHS.
KW - Hemodynamics
KW - Hypoplastic left heart syndrome
KW - Norwood procedure
KW - RV-PA shunt
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M3 - Article
C2 - 15500101
AN - SCOPUS:4644372004
VL - 53
SP - 1008
EP - 1013
JO - Japanese Journal of Anesthesiology
JF - Japanese Journal of Anesthesiology
SN - 0021-4892
IS - 9
ER -